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Oversee case management and appeals, including identifying, communicating, and educating staff on governmental regulations. * Trained Staff on appeals and case management protocols.* Centralized the Humana revenue integrity audit denial appeal process.* Managed revenue integrity audit appeal and prevention for 206 hospitals, achieving a 70+% success rate.* Countered concurrent denials and streamlined government denial appeals for RAC, MAC, and CERT.* Coached staff on leveraging Milliman care to fight concurrent denials; employed InterQual Utilization Review methodologies.* Built a physician advisor mentoring structure; created a remote physician advisor program.* Improved 2 midnight rule adoption by implementing process improvement calls, delivering education, and providing real-time feedback; implemented self-audit protocols.* Integrated acquired facilities into the appeals structure and transitioned facilities.* Hired a DBA to manage vendor relations and provide IT support.

Managed registrations for a system growing from 10 to 28 facilities. Advised on PBX, registration, financial counseling, process improvement, and case management.* Evaluated facility compliance with policies, procedures, and payer requirements.* Appointed interim hospital patient access director as warranted.* Secured patient satisfaction and fiscal result improvements.* Realized a 17% decrease in staff turnover and improved overall performance.* Maximized collections by enforcing POS collections and implementing processes at 12 hospitals, capturing a 15% YOY improvement.* Trained patient access leaders and developed training on insurance selection.* Deployed quality check and patient estimator software; established a centralized pre-registration unit.* Realized a 75% decrease in billing delays by implementing best practices.* Supported acquisitions by training staff on culture, processes, and systems.* Developed a reporting process to track POS collections and bad debt reduction.

Directed access management services, supporting a 865 bed academic medical center, holding responsibility for coordinating change management. Administered a $16 million patient financial services budget as interim Senior Director. * Increased monthly collection amounts $9 million by developing a revenue cycle dashboard to track change improvements.* Served on a multi-disciplinary team to improve the authorization process for inpatient and high value drug claims.* Hired a training lead and created a supervisor training program for patient financial services and registration leaders.* Captured expense reductions by designing a contract management process to eliminate contract auto-renewals.* Implemented compliance controls and assisted case management in making changes to ensure adherence with CMS rules.* Contributed to resolving billing and denial technical issues; increased reported revenue and collections.

Led case management department improvement, maintained admissions, and enhanced POS collection across a 265 bed facility.* Increased staff retention.* Reduced the use of the emergency department for routine care and increased provider and patient satisfaction by launching a case management program; increased POS cash collection $4 million in one year.* Managed clinical documentation enhancements to improve the mortality index and reimbursement.* Integrated case management into the hospital revenue cycle.* Streamlined utilization management, increasing accuracy and reducing Medicare take-backs and denials.* Redesigned functions to reduce discharge delays and improve nurse and social work performance.* Established a physician-led case management steering committee.* Resolved a CMS compliance issue requiring self-reporting with no corporate integrity agreement.* Oversaw revenue-cycle conversion from Meditech Magic to Client Server.* Served as alpha client for the Recondo tool.